Predictors of locoregional control in stage I/II oral squamous cell carcinoma classified by AJCC 8th edition

Subramaniam, Narayana; Balasubramanian, Deepak; Murthy, Samskruthi; Kumar, Narender; Vidhyadharan, Sivakumar; Vijayan, Smitha N.; Nambiar, Ajit; Thankappan, Krishnakumar; Iyer, Subramania

doi:10.1016/j.ejso.2019.05.018

Cited by 21 publications

(8 citation statements)

References 21 publications

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“…Thus, an increase in the depth of invasion probably precedes and influences perineural and perivascular invasions. In addition, perineural invasion and WHO grading system could be included in TNM classification for a more complete variable, because these are the most predictable variables, as suggested by Subramaniam, et al 25 (2019), using the new edition of TNM, and also our study, using the 7 th edition.…”

Section: Discussionmentioning

confidence: 83%

How pathological criteria can impact prognosis of tongue and floor of the mouth squamous cell carcinoma

et al. 2020

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Pathological parameters have been indicated as tumor prognostic factors in oral carcinoma.Objective:The objective of this study was to investigate the impact of pathological parameters on prognosis of patients affected only by tongue and/or floor of the mouth squamous cell carcinoma (SCC).Methodology:In total, 380 patients treated in the Brazilian National Cancer Institute (INCA) from 1999 to 2006 were included. These patients underwent radical resection followed by neck dissection. The clinical and pathological characteristics were recorded. The Kaplan-Meier method and Cox proportional hazards model were used in survival analysis. Overall survival (OS), cancer-specific survival (CSS) and disease-free interval (DFI) were estimated. Cox residuals were evaluated using the R software version 3.5.2. Worst OS, CSS and DFI were observed in patients with tumors in advanced pathological stages (p<0.001), with the presence of perineural invasion (p<0.001) and vascular invasion (p=0.005).Results:Advanced pathological stage and the presence of a poorly differentiated tumor were independent prognostic factors for OS and CSS. However, advanced pathological stage and perineural invasion were independent predictors of a shorter OS, DFI and CSS.Conclusion:Pathological stage and perineural invasion were the most significant pathological variables in survival analysis in tongue and/or floor of the mouth SCC.

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Section: Discussionmentioning

confidence: 83%

How pathological criteria can impact prognosis of tongue and floor of the mouth squamous cell carcinoma

et al. 2020

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“…In early (stage I/II) cancers, up to a third of adequately treated patients can develop locoregional recurrences, which have been noted to have a strong correlation with adverse pathological features like perineural invasion (PNI), lymphovascular invasion (LVI) and degree of differentiation, which have so far not been incorporated into the staging system. 5 In advanced (stage III/IV) cancers prognostication based on tumor dimension with/without nodal spread alone also seems inadequate. This forms a highly heterogeneous group of patients in whom prediction of survival solely based on stage is unreliable.…”

Section: Introductionmentioning

confidence: 99%

“…Although the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) 8th edition TNM staging systems for oral cancer 4 has shown improved performance when compared with previous systems, this classification, however, still remains largely insufficient. In early (stage I/II) cancers, up to a third of adequately treated patients can develop locoregional recurrences, which have been noted to have a strong correlation with adverse pathological features like perineural invasion (PNI), lymphovascular invasion (LVI) and degree of differentiation, which have so far not been incorporated into the staging system 5 . In advanced (stage III/IV) cancers prognostication based on tumor dimension with/without nodal spread alone also seems inadequate.…”

Section: Introductionmentioning

confidence: 99%

Predictive nomograms for oral tongue squamous cell carcinoma applying the American Joint Committee on Cancer/Union Internationale Contre le Cancer 8th edition staging system

et al. 2021

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Background: Nomograms applying the 8th edition of the TNM staging system aimed at predicting overall (OS), disease-specific (DSS), locoregional recurrence-free (LRRFS) and distant recurrence-free survivals (DRFS) for oral tongue squamous cell carcinoma (OTSCC) are still lacking. Methods: A training cohort of 438 patients with OTSCC was retrospectively enrolled from a single institution. An external validation set of 287 patients was retrieved from two independent institutions. Results: Internal validation of the multivariable models for OS, DSS, DRFS and LRRFS showed a good calibration and discrimination results with optimism-corrected c-indices of 0.74, 0.75, 0.77 and 0.70, respectively. The external validation confirmed the good performance of OS, DSS and DRFS

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“…Although it is a robust staging system, factors that upstage tumors like tumor dimension and masticator space involvement can vary significantly with the anatomical location of the tumor and adjacent barriers to tumor spread. Moreover, incorporation of adverse features that are likely to reflect tumor biology has been previously shown by our group to improve precision in staging of early oral cancers 2,9 . However, the hazard discrimination in advanced tumors (pT3‐4) in our cohort remained poor (Figure 1).…”

Section: Discussionmentioning

confidence: 71%

Incorporation of adverse features in advanced oral cancer improves precision in staging and patient prognostication

et al. 2022

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Background Despite revised staging criteria, stratification of patients with advanced oral squamous cell carcinoma (OSCC) remains difficult. Well‐established features like perineural invasion (PNI), differentiation, and lymphovascular‐invasion (LVI) are controversial, and hence omitted from staging. We endeavor to better stratify this cohort by identifying predictors of survival in advanced OSCC (T3‐4). Methods Seven hundred and forty‐two patients with T3‐4 OSCC underwent surgery from 2006 to 2013. Cox regression was performed to determine predictors of overall survival (OS). Results OS was adversely impacted by PNI (p = 0.046), LVI (p = 0.038), moderate/poor differentiation (p = 0.001), close/involved surgical margins (p = 0.002), pT (p = 0.034), and pN (p < 0.001). The cumulative number of adverse histopathological features predicted poorer OS; HR 2.64 (CI 1.42–4.90) for one adverse feature and HR 4.23 (CI 2.34–7.67) for ≥2. Conclusion In advanced OSCC, stratification with histopathologic risk factors can predict survival even in maximally treated patients; adjuvant therapies are unable to entirely mitigate this risk. Incorporation of adverse features into future editions of TNM can improve precision in staging and identify candidates for treatment escalation.

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Predictors of locoregional control in stage I/II oral squamous cell carcinoma classified by AJCC 8th edition

Cited by 21 publications

References 21 publications

How pathological criteria can impact prognosis of tongue and floor of the mouth squamous cell carcinoma

How pathological criteria can impact prognosis of tongue and floor of the mouth squamous cell carcinoma

Predictive nomograms for oral tongue squamous cell carcinoma applying the American Joint Committee on Cancer/Union Internationale Contre le Cancer 8th edition staging system

Incorporation of adverse features in advanced oral cancer improves precision in staging and patient prognostication

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